For too many years, stigma and a lack of knowledge has contributed to the alarming statistic that persons with a mental illness/serious psychiatric disorder are dying 25 years earlier than a typical person who doesn’t have a mental illness.
Many people want to know who or what a typical person is. A good part of that answer is the nurses that took part in the Framingham Heart Study. Boston University started that study in 1948 and there is a lot of data to be found there.
Regarding people dying 25 years early, it is easy to cast blame. It’s easy to say, you eat too much or you smoke too much and did I mention that you don’t exercise? But the reality is that the alarming death rate is a combination of factors.
In 2004, four organizations (American Diabetes Association, American Psychiatric Association, American Association of Clinical Endocrinologist, and the North American Association for the Study of Obesity, held a Consensus Development Conference on Anti-psychotic Drugs and Obesity and Diabetes. They issued guidelines for baseline screening and ongoing monitoring related to obesity and diabetes.
Even knowing that this population was dying 25 years early there was little action that happened to change anything. In 2008 the National Association of State Mental Health Program Directors (NASMHPD) issued a technical report called Measurement of Health Status for People with Serious Mental Illnesses. Some places started noticing, but many mental health service providers are still lagging behind.
It’s easy to say, people with a mental illness/serious psychiatric disorder are dying 25 year early, but to best know how to help people and be willing to do so still seems to be a struggle.
There are a lot of discussions that happen where people try to say, people are dying because they are smoking, for example this quote is on the website of the National Alliance on Mental Illness (NAMI). “People living with mental illness have a very high rate of smoking. A study by The Journal of the American Medical Association reported that 44.3 percent of all cigarettes in America are consumed by individuals who live with mental illness and/or substance abuse disorders. This means that people living with mental illness are about twice as likely to smoke as other persons.” So it’s easy to blame the cigarettes.
It’s easy to say, people need to get out and exercise more, that will solve the problem. We can start a group for that. Or that people need to eat less, let’s send them to the dietitian. Or that people need to change what they are eating.
There is a huge push right now for there to be integration of mental and physical health care. Service providers of the people who are dying 25 years early, grapple with what it will mean for mental and physical health care to be integrated. Parents grapple with what it will mean for their family member. The people who have the psychiatric diagnosis wonder what it will mean for mental and physical health care to be integrated. Yet, when persons with a mental illness use an emergency room, mental health care and physical health care are integrated, often with a disastrous effect.
Mental Health Providers all too often pass the buck when it comes to looking at the physical side of mental health, yet mental health is physical health. There are two main tests that could be done consistently that would keep people being served knowing just how important keeping up with their physical health is. Weight and waist circumference is not checked, yet we know that with metabolic syndrome those two factors are crucial. A person may not be seen for two or three months, even after starting a new psychotropic medication.
There is another quote in the NASMHPD that states; “The increased morbidity and mortality is largely due to treatable medical conditions caused by modifiable risk factors such as smoking, obesity, substance abuse, psychotropic medication side effects and inadequate access to medical care.
Too often psychotropic medication side effects are looked at last, much later than they should be. Inadequate access to medical care often includes poor access to smoking quit kits, with little to no information on obesity and substance abuse as it pertains to people with a psychiatric diagnosis.
To stop people from dying 25 years early, there are five things that must happen.
- People must feel hope, that life is worth living and that their life can be better.
- It is possible for them to gain control of both their physical and mental health.
- To gain control, one can start anywhere. If they are not ready to stop smoking, then start somewhere else and that it is their decision.
- Little changes count. You don’t have to change everything all in one day.
- You don’t have to wait to start. You can start today.